Drugs for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists

The hepatotoxic effect is fully reversible upon discontinuation of the drug (Lau et al., 2017). Because embryo-fetal defects also have been reported, bosentan should be used only after confirming a negative pregnancy test. According to the CHEST treatment guidelines, macitentan should be chosen for...

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Bibliographic Details
Published inMedsurg nursing Vol. 29; no. 4; pp. 259 - 266
Main Authors Reynaldo, Rhea Faye D. Felicilda, Inocian, Ergie P
Format Journal Article
LanguageEnglish
Published Pitman Jannetti Publications, Inc 01.07.2020
Anthony J. Jannetti, Inc
Subjects
Antihypertensive agents
Cell growth
Clinical outcomes
Contraindications
Drug therapy
Edema
Endothelin
Endothelium
FDA approval
Heart failure
Lungs
Nitric oxide
Nurses
Nursing
Pathophysiology
Peptides
Pregnancy
Prescription drugs
Pulmonary arteries
Pulmonary hypertension
Smooth muscle
Survival analysis
Veins & arteries
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Summary:The hepatotoxic effect is fully reversible upon discontinuation of the drug (Lau et al., 2017). Because embryo-fetal defects also have been reported, bosentan should be used only after confirming a negative pregnancy test. According to the CHEST treatment guidelines, macitentan should be chosen for initial therapy if the patient cannot tolerate the combined therapy of ambrisentan (Letairis®) and PDE-5 inhibitors, and if the goal of treatment is to delay disease progression (Klinger et al., 2019). No significant difference was found in patient exercise capacity between bosentan and macitentan; however, macitentan was inferior to ambrisentan in improving patient exercise capacity (Bedan et al., 2018). Because macitentan is contraindicated during pregnancy due to teratogenic effects, a pregnancy test must be completed before starting a female patient on the medication (Drugs.com, 2018). According to CHEST treatment guidelines, ambrisentan often is combined with phosphodiesterase-5 (PDE-5) inhibitors, usually tadalafil (Klinger et al., 2019).
ISSN:1092-0811
2995-4037